https://scholars.lib.ntu.edu.tw/handle/123456789/478616
標題: | Peritoneal dialysis peritonitis by anaerobic pathogens: A retrospective case series | 作者: | CHIA-TER CHAO SZU-YING LEE WEI-SHUN YANG HUEI-WEN CHEN CHENG-CHUNG FANG CHUNG-JEN YEN CHIH-KANG CHIANG KUAN-YU HUNG JENQ-WEN HUANG |
公開日期: | 2013 | 卷: | 14 | 期: | 1 | 起(迄)頁: | 111 | 來源出版物: | BMC Nephrology | 摘要: | Background: Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods. We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patients receiving more than 3 months of PD were enrolled. We analyzed clinical features as well as outcomes of anaerobic PD peritonitis patients. Results: Among 6 patients, 10 episodes of PD-associated peritonitis were caused by anaerobic pathogens (1.59% of all peritonitis episodes during study the period), in which the cultures from 5 episodes had mixed growth. Bacteroides fragilis was the most common species identified (4 isolates). Only 3 episodes were associated with gastrointestinal lesions, and 4 episodes were related to a break in sterility during exchange procedures. All anaerobic pathogens were susceptible to clindamycin and metronidazole, but penicillin resistance was noted in 4 isolates. Ampicillin/sulbactam resistance was found in 2 isolates. In 5 episodes, a primary response was achieved using the first-generation cephalosporin and ceftazidime or aminoglycoside. In 3 episodes, the first-generation cephalosporin was replaced with aminoglycosides. Tenckhoff catheter removal was necessary in 2 episodes. Only one episode ended with mortality (due to a perforated bowel). Conclusion: Anaerobic PD-associated peritonitis might be predominantly caused by contamination, rather than intra-abdominal events. Half of anaerobic PD-associated peritonitis episodes had polymicrobial growth. The overall outcome of anaerobic peritonitis is fair, with a high catheter survival rate. ? 2013 Chao et al.; licensee BioMed Central Ltd. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/478616 | ISSN: | 1471-2369 | DOI: | 10.1186/1471-2369-14-111 | SDG/關鍵字: | amikacin; aminoglycoside antibiotic agent; amphotericin B; ampicillin plus cloxacillin; cefazolin; cefepime; ceftazidime; cephalosporin; cilastatin plus imipenem; clindamycin; gentamicin; meropenem; metronidazole; penicillin derivative; tobramycin; vancomycin; adult; aged; antibiotic resistance; antibiotic sensitivity; antibiotic therapy; article; bacterial growth; bacterial peritonitis; bacterium contamination; bacterium culture; bacterium identification; bacterium isolate; Bacteroides fragilis; Bacteroides infection; Bacteroides thetaiotaomicron; catheter removal; cause of death; clinical feature; digestive system injury; disease association; drug substitution; drug withdrawal; female; hemodialysis patient; hospital acquired pneumonia; human; intestine perforation; Lactobacillus; major clinical study; male; Peptostreptococcus; peritoneal dialysis; retrospective study; treatment response; adverse effects; anaerobic bacterium; Bacterial Infections; cohort analysis; medical device contamination; middle aged; peritoneal dialysis; peritonitis; prevention and control; prospective study; young adult; Adult; Aged; Bacteria, Anaerobic; Bacterial Infections; Cohort Studies; Equipment Contamination; Female; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritonitis; Prospective Studies; Retrospective Studies; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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